200810193 I ` ' e. 2&z4oT NO. J
NO. STREET
® ,P61.�,4 1 ', �FOR PLUMBING PERMIT
�Y-OF CUPERTINO
`j APR 5 1963 '' % sanitary No.
Date 196— Permit No, =2,9 a
��JaY! OF QUPVTINO'Fee $ —
Ap i a ion is here y ma e to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or -fixtures in accordance with the provisions of the Plumbing Code of_the City of
s Cupertino;)5hd all other,l3ws%aplicable the et
Use of Premises //wE2�:^ �� a i-.(/�li w'
Oatrcr� : _ Address
b J '`=
Approved.♦,
' .•'
PLUMBING
UNITS FEES
UNITS1 FEES
Water lk"ter
Size
Water Closets
Materia;'
Bath Tubs
To Curb
Showers
To Prop. 'Line
Lavatories
To Existing "
Kitchen Sinks
Not Conn. .y
Dish Washers
Sewer Boxes
Waste Disposals
Wash Trays
STORM DRAINAGE "
WAshing,Machines
Size _ t
Water Softene-rs,
Material
Bar Sinks -
To Main Drain `
Comb. :Sink'&.Trays
Dental Units,-; '
Drinking FountainsFloor Drains" -
"ii
�IHoppers
Size
Restaurant Sinks
Material; '
Sand Trans.
TOTAL FEES-.�
xture
sprinkler Vmves T IZ��' Water Sys. Pee ' ( n
RECORD OF INSPECTION. ' .+$
Main Drain ; 11